Abstract
One of the main goals of the 2016 Global Health Sector Strategy on viral hepatitis is the elimination of hepatitis C virus (HCV) as a public health problem by 2030, defined as an 80% reduction in incidence and 65% reduction in mortality relative to 2015. Although monitoring HCV incidence is key to validating HCV elimination, it can be resource-intensive for countries to measure this metric using the gold-standard method, which involves prospective HCV re-testing of people at risk. Additionally, few countries have collected quality data in 2015 to document an 80% decrease by 2030. In this paper, we first review different methods by which HCV incidence can be monitored and discuss their resource implications and applicability to various populations. Second, using mathematical models developed for various global settings, we assess whether trends in HCV chronic or antibody prevalence or scale-up levels for HCV testing, treatment and preventative interventions can be used as reliable alternative indicators to validate the HCV incidence target. Third, we discuss the advantages and disadvantages of an absolute HCV incidence target and suggest a suitable threshold. We then propose three options that countries can use to validate the HCV incidence target, depending on the available surveillance infrastructure.
| Original language | English |
|---|---|
| Pages (from-to) | 353-366 |
| Number of pages | 14 |
| Journal | The Lancet Gastroenterology and Hepatology |
| Volume | 7 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2 Feb 2022 |
Bibliographical note
Funding Information:This work was commissioned and paid for by WHO. Copyright in the original work on which this article is based belongs to WHO. The authors have been given permission to publish this article. The original modelling studies used in the article are the intellectual property of the respective authors. The Global HIV, Hepatitis, and Sexually Transmitted Infections Programmes at WHO had an active role in the design, conduct, and analysis of the study, interpretation of the data, and writing of the report. The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions, or policies of WHO. AA is supported through postdoctoral fellowships from the Canadian Institutes of Health Research, Fonds de la Recherche en Santé du Québec, and the Canadian Network on Hepatitis C. LJA-R and HHA acknowledge support by the National Priorities Research Program (grant number 12S-0216–190094) from the Qatar National Research Fund (a member of Qatar Foundation). NKM, PV, HF, JS, and AGL acknowledge support from the National Institute of Allergy and Infectious Diseases NIDA (R01 AI147490) and NIDA (grant number R01 DA033679, R01 DA037773, R21 DA046809, R21 DA047902, and R01 DA047952). LKM acknowledges support from the National Institute of Drug Abuse, National Institutes of Health (grant number T32 DA023356). NKM is also funded by the University of California San Diego Center for AIDS Research (P30 AI036214). PV, AGL, JS, and MH received funding from the Health Protection Unit for Evaluation of Interventions and Behavioural Science funded by the UK National Institute for Health Research.
Funding Information:
PV and JGW have received unrestricted research grants from Gilead, outside the submitted work. JGW has also recieved a research grant from FIND outside the submitted work. NM has received unrestricted research grants from Gilead and Merk outside the submitted work. MH has received speaker fees honoraria in past 5 years from Gilead and Merck Shape & Dohme (MSD). HF has received an honorarium from MSD unrelated to this research. HF, ZW, and PV declare payment to their institution from WHO to prepare a background paper that formed the basis for this paper. All other authors declare no competing interests.
Funding Information:
This work was commissioned and paid for by WHO. Copyright in the original work on which this article is based belongs to WHO. The authors have been given permission to publish this article. The original modelling studies used in the article are the intellectual property of the respective authors. The Global HIV, Hepatitis, and Sexually Transmitted Infections Programmes at WHO had an active role in the design, conduct, and analysis of the study, interpretation of the data, and writing of the report. The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions, or policies of WHO. AA is supported through postdoctoral fellowships from the Canadian Institutes of Health Research, Fonds de la Recherche en Santé du Québec, and the Canadian Network on Hepatitis C. LJA-R and HHA acknowledge support by the National Priorities Research Program (grant number 12S-0216–190094) from the Qatar National Research Fund (a member of Qatar Foundation). NKM, PV, HF, JS, and AGL acknowledge support from the National Institute of Allergy and Infectious Diseases NIDA (R01 AI147490) and NIDA (grant number R01 DA033679, R01 DA037773, R21 DA046809, R21 DA047902, and R01 DA047952). LKM acknowledges support from the National Institute of Drug Abuse, National Institutes of Health (grant number T32 DA023356). NKM is also funded by the University of California San Diego Center for AIDS Research (P30 AI036214). PV, AGL, JS, and MH received funding from the Health Protection Unit for Evaluation of Interventions and Behavioural Science funded by the UK National Institute for Health Research.
Publisher Copyright:
© 2022 World Health Organization. Published by Elsevier Ltd. All rights reserved.